Staph Infections Lead To Latest Call For Basic Hygiene
October 29, 2007
Hand washing.
Health experts can't say it enough. It's your best defense against a myriad of illnesses.
"Rubbing them together (vigorously) is more important than the soap that's on them," said Dr. Raymond Coghlan, an infectious disease specialist in Shreveport.
Concern over the spread of an evolved bacterium that's learned new ways to dupe the human immune system — a "super bug" in the world of single cells — has prompted the latest call for common-sense hygiene.
Methicillin-resistant staphylococcus aureus (MRSA) is a multidrug-resistant form of the bacterium staphylococcus aureus, "staph."
The bacterium has recently been in the headlines after researchers suggested the germ could be causing more deaths annually than AIDS.
The study, which focused on the invasive form (in the bloodstream) of the illness, was published in the October edition of the Journal of the American Medical Association. It was led by researchers from the Centers for Disease Control and Prevention and suggested as many as 18,000 Americans may die each year from the bacterium.
The news has fed a media frenzy with increased public awareness drawn to deaths, especially of school-aged children, caused by MSRA.
"Twenty-one schools closing was not necessary," said Dr. Lisa Hodges of pediatric infectious disease at LSU Health Sciences Center, referring to a news report from Virginia. "That's created this environment of chaos."
The real news in the report, said specialists, is that MRSA has steadily been moving outside of hospitals where it's been since 1968 and moving into the community (CA-MRSA), affecting otherwise healthy individuals.
The report still found that most, 85 percent, of all cases still occur in the health-care area (HA-MRSA).
Hodges and physicians see staph often
If you've ever had a boil, a scaling-looking skin infection or a tender area you thought was a spider bite, it's probably been caused by staph. "Spiders have taken a great deal of credit for staphylococcus aureus," Coghlan said.
And today, about 70 percent of the time, the staph infections in the community are MRSA, added Coghlan.
Most cases are minor. Some pass without any antibiotics at all, said Hodges and others are generally treated the same way as the nonresistant strains.
While MRSA is resistant to all the penicillins and another group antibiotics, cephalosporins, said Coghlan, it still has at least three drugs that are effective.
There is a valid concern, agree specialists, that while CA-MRSA is still susceptible to more drugs then HA-MRSA, it also has a very virulent evil side that separates it from its hospital counterpart. And gives the public one more reason to get a flu shot.
One rogue gene in a strain of CA-MRSA, Panton-Valentine Leukocidin, is believed to be the villain in 10 cases of influenza associated, severe pneumonia. The infections caused the death of six of the 10 cases found in Louisiana and Georgia during the months of December 2006 to January. The cases were written up in the CDC weekly mortality and morbidity report April 13.
"Yes, we've seen this strain cause severe invasive disease in kids," Hodges said. "We have a case now of a child with pneumonia MRSA, but what we see most, about 95 percent of the time, is only skin and soft tissue infection."
Schools are also well aware of staph and MRSA, although they may not always know when a child comes to school with a staph infection.
"Parents don't have to tell us, that's true for all diseases," said Ginger Hughes, nurse supervisor for Bossier Parish schools. "That's why we teach universal precautions, like washing hands and not sharing items like drinks."
Sports are an especially heightened area of interest when it comes to protecting students from staph infections.
"We've gotten information on MRSA from the superintendent, the Louisiana High School Athletic Association, office staff and cafeteria program," said Bossier City Parkway High School Principal Joe Huffman. "Our basic cleaning already addresses these reminders. There's always a heightened awareness."
Airline High School Principal Kim Gaspard has had to reminded his students to wash their hands often and not to share drinks.
"We had a little problem last year and had some kids come to school with it at the start of the year," Gaspard said. "We disinfect our equipment often and ... we started cleaning the baseball and softball fields as well to make sure the places that people put their hands on a lot like knobs on a water faucet were cleaned."
Daily cleaning is always a good plan, says Coghlan, but it doesn't have to be anything more than normal.
"It's mostly spread by skin-to-skin contact, and knowing that, you have to wash your hands," said Coghlan. "It's a super bug but it can't leap tall buildings and it usually dies in a short period of time."
Probably the biggest concern with MRSA for the medical field is that it's just one of an emerging army of drug-resistant bacteria. Over time bacteria naturally evolves, but put a fence in front of it, like an antibiotic, and it learns to climb over even faster.
It's an ongoing problem
"More than $5 billion a year is spent on the treatment of resistant organisms," Coghlan said. "Pharmaceuticals are not keeping up."
Coghlan does see hope in other research areas for MRSA.
"Further research needs to be done in why this organism is so sticky (sets up shop on the human skin) compared to the old and look into the enzymes it makes to propagate the infection and how to interfere with that," he said. "There are new antibiotics coming out, but that's how to treat the infection. I think we'll find a way to interfere with its attachment."
